儿童变应性鼻炎舌下特异性免疫治疗的近期疗效观察

目的　观察舌下特异性免疫治疗（sublingual immunotherapy，SLIT）应用于治疗儿童变应性鼻炎的近期临床疗效。方法　采用前后自身对照，比较44例3～13岁尘螨过敏的变应性鼻炎患者治疗前及治疗3、6个月的症状评分、药物评分、视觉模拟量表（visual analogue scale，VAS）评分及血液嗜酸性粒细胞（eosinophil，Eos）水平，评价SLIT的近期临床疗效。结果　SLIT治疗3个月和6个月后，患者的鼻部症状评分、药物评分及VAS评分较治疗前显著下降，差异有统计学意义（P 均<0.05）；SLIT治疗3个月与治疗6个月相比，患者鼻塞、流涕、喷嚏症状评分，鼻部总症状评分、药物评分及VAS评分相似，差异无统计学意义（P 均>0.05），而鼻痒症状评分差异具统计学意义（Z =-4.185，P <0.05）；SLIT治疗6个月与治疗前相比，血液Eos水平显著下降，差异具有统计学意义（Z=-4.544，P<0.05）。结论　舌下含服标准化粉尘螨滴剂是治疗尘螨变应性鼻炎儿童患者的一种安全有效的治疗方法，可在治疗3个月左右观察到疗效，SLIT治疗6个月后患者Eos百分比显著降低。

Short-term clinical efficacy of sublingual immunotherapy in children with allergic rhinitis

OBJECTIVE To investigate the short-term clinical efficacy of sublingual immunotherapy in children with allergic rhinitis. METHODS Forty-four patients, from 3-14 years of age, with mite-sensitive allergic rhinitis were treated sublingually with standardized dermatophagoidesfarinae extract. After treatment of 3 or 6 months using the dermatophagoidesfarinae extract, the total nasal symptoms score(including nasal congestion, nasal itching, rhinorrhea and sneezing scores), total rhinitis medicine scores, visual analog scale scores and the percentage of blood eosinophilic granulocyte(Eos%) before and after treatment were evaluated. SPSS 20.0 software was used to analyze the data. RESULTS After 3 or 6 months' treatment,thenasal symptoms score(including nasal congestion, nasal itching, rhinorrhea and sneezing scores), total rhinitis medicine scores and visual analog scale scoreshad significantly reduced,comparing with that before treatment(all P<0.05). The comparison of the total nasal symptoms score(including nasal congestion, rhinorrhea and sneezing scores), total rhinitis medicine scores and visual analog scale scores between 3 months and 6 months treatment had shown no significant difference (all P>0.05), while nasal itching scores had significantly reduced(Z=-4.185, P<0.05). After 6 months' treatment, the percentage of Eos% had significantly reduced compared with that before treatment(Z=-4.544, P<0.05). CONCLUSION SLIT could be an effective treatment in patients with allergic rhinitis sensitive to house dust mite. It would have effect after3 months treatment and Eos%reduced significantly after 6 months treatment.